Factors influencing the prognosis of patients with pancreatic cancer after intended radical surgery

doi:10.19538/j.cjps.issn1005-2208.2017.07.20

Abstract：Objective To analyze the factors influencing the prognosis of patients with pancreatic cancer after intended radical surgery. Methods The clinical data of 275 cases of pancreatic cancer accepted intended radical surgery in Pancreas Center of the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2013 were analyzed retrospectively. Results A total of 216 cases(78.5%)died during 18(9-36)months of follow-up. The overall median survival time was 15.1(95%CI 11.7-18.4)months. The 1-,3-,5-year survival rates were 63.2%,23.1%,11.8%, respectively. The median survival time of patients received adjuvant chemotherapy was 29.1(19.5-38.7)months. The 1-,3-,5-year survival rates were 78.6%, 43.6%, 25.4%,respectively. Cox regression model showed that preoperative serum CA19-9,differentiation of tumor,tumor size,microscopic vascular invasion,positive nodal ratio,adjuvant chemotherapy were the independent risk factors influencing the prognosis of patients with pancreatic cancer after intended resection(P<0.05). Further stratification analysis showed preoperative serum CA19-9,differentiation of tumor, tumor size,microscopic vascular invasion,adjuvant chemotherapy were the independent risk factors influencing the prognosis of patients with pancreaticoduodenectomy(P<0.05),and differentiation of tumor,positive nodal ratio, microscopic vascular invasion,adjuvant chemotherapy were the independent risk factors influencing the prognosis of patients with distal pancreatectomy. Conclusion Pancreatic cancer patients,either in the head or body-tail, with higher preoperative CA19-9, higher positive nodal ratio, and poorer tumor differentiation and microscopic vascular invasion have a worse prognosis. Adjuvant chemotherapy, which can significantly prolong patients' survival after radical resection, should be encouraged.